Organization
DONALD V.JACKSON, DC,PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DONALD VANCE JACKSON D.C. (DR)
(512) 451-4006
Entity
Organization
Contact information
Practice address
1408 W KOENIG LN, AUSTIN, TX 78756-1426
(512) 451-4006
Mailing address
1408 W KOENIG LN, AUSTIN, TX 78756-1426
(512) 451-4006
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
4460
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00Y349
BCBS 0051QP
TX
Enumeration date
06/18/2007
Last updated
02/26/2008
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